Pederzol, Bert

Pederzol, Bert is an sole proprietor health care provider with primary practice located at 1650 S Union Ave , Alliance OH 44601-4349. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Pederzol, Bert can be contacted via phone (330) 630-9699.

Contact Information

Primary practice address
1650 S Union Ave Alliance OH 44601-4349
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3261 Ohio

Profile Details

NPI number 1649338112
LBN Legal business name Pederzol, Bert
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 5th, 2006
Last updated Jun 8th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649338112 NPPES
Ohio MEDICAID 0311219
Ohio Other 000000131061

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